Communication Discrimination
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Hi Everyone,
I have entered a National speaking competition and have chosen a subject that we nurses experience on a daily basis; people being spoken to or treated differently because of the way... Read More

I love accents and didn't realize it was so offensive to comment on or ask about them.

The act of inquiring about an accent is not offensive by itself. Rather, it is the manner in which the person asks that can come across as offensive or rude.

One time I was told, "You sound funny, like a Valley girl. Where are you from?"

Let's flip the script. The woman who made the comment probably wouldn't like it if I said, "You sound funny with that thick southern drawl, like a country bumpkin. Which state in the South are you from?

Mar 14, '17

One so-called "nurse"who practically tortured me every single working shift by making fun out of my English among other things, got a really bad dental job done after I was done in that unit. She ended up with unilateral CN VII motor paralysis and a "high" trache, which left her with a very strange sounding "accent". After we accidentally bumped into each other about a year after all that was going on, she was practically crying on my shoulder, begging for forgiveness.

To play the devils advocate, I think it's really hard to accurately assess someone's communication ability right from the beginning. I mean really, you have to engage them in meaningful conversation before that can happen, right? So I can see how people might want to assume the person has limited understanding from the start and adjust rather than start complex and move the other way. We've all had that experience when the other person responds minimally because we've assumed too much. Depending on what we have to say and how much time we have to get our point across, it may be better to assume a limited communicative ability.

Anyway, I do agree though that assuming someone has limited understanding can be insulting. I was a personal care attendant to a woman with physical disabilities. I helped her run errands sometimes. On our trips I found that if I was wearing scrubs, the store staff was more likely to defer to me for questions, even if she initiated the verbal exchange. I would have to redirect them to ask her. She always handled it with grace but it open my eyes to how people with disabilities are spoken to inappropriately.

I can appreciate this point of view to a certain degree. But this is the purpose of the initial assessment that helps to determine admission, and the subsequent shift assessments and reassesments to help move towards discharge. So, to have patients labeled as confused from the date of admission to the date of discharge when they are not is totally unacceptable.

I see so many nurses who simply document what the previous nurse had, in the interest of time management...gotta get those assessments in, right? If these findings are never upgraded to reflect the patient's neurological status appropriately or accurately, how do we justify stability for discharge? Or resolve care plans appropriately?

A lot of nurses form their opinions (prejudge) during shift report, and have already decided that they were not going to spend (waste) any time in those rooms before even entering them. We've all been guilty of these thoughts at some point because of having so much to do, with so little time to accomplish things. But before we document, please go in and confirm any abnormal disclosures during the report.

The act of inquiring about an accent is not offensive by itself. Rather, it is the manner in which the person asks that can come across as offensive or rude.

One time I was told, "You sound funny, like a Valley girl. Where are you from?"

Let's flip the script. The woman who made the comment probably wouldn't like it if I said, "You sound funny with that thick southern drawl, like a country bumpkin. Which state in the South are you from?

TheCommuter---thank you! I had to chuckle when I read your comment about flipping the script. As a Texan who lived in MA for 3 years, I have a few stories I could tell :-). I am curious about accents, but I do try to be respectful when I ask where someone is from. Thanks for the caution on how to ask without offending---never my intent, but I can see how the delivery of questions about origin could be viewed that way.

Mar 14, '17

OP---I don't know if this fits, but here are my "peeves" about communication.

1. Please don't assume that just because I have white hair I am hard of hearing.
2. Please don't call me "Sweetie". "Ma'am" would be okay, or Mrs. Kakamegamama, but please, not "Sweetie". I've never liked hearing older people addressed that way, and don't like it for myself, either. In the Southern United States, it is usually not meant condescendingly, but it usually comes across that way, at least to me.
3. It's okay that people sound different than we do. Ask for clarification if you think you heard something different than what you planned to hear. It may be a matter of wrong words usage, or perhaps the person you spoke to didn't fully understand your question.
4. Don't make fun of colloquialisms, especially to the speaker, unless you yourself use those same colloquialisms.

I'm not sure if this fits your criteria, but I have worked with a certain Dr for most of the last 15 years. He apparently thinks every one of his patients are hard of hearing, because he practically yells at them when talking. It drives me completely bonkers!!

Is he hard of hearing? Also, some people confuse speaking loudly with messaging clearly.

In my observations, nurses who have "speech problems" should think twice before accepting jobs in facilities which already have red flags for discrimination of any kind, such as:
- religious organizations - based;
- racial demographics is substantially different from surrounding area;
- claims to "no tolerance of discrimination" or "equal opportunity" expressed more than the mandatory phrasing on job application;
- 1 or more claim with EEOC over the last 10 years (public info);
- feeders for local high-ranked or high-prestige brick-and-mortar graduate programs;
- recent significant economic changes in the area (either way);
- area with history of ethnic/racial tension/discrimination.

I believe your criteria will eliminate all potential employment. No institution is perfect and each one is made up of individuals who are not perfect either. What you want to look for is a commitment to equality. You need to elaborate on your criteria, such as religious organizations. They automatically discriminate based on their beliefs, and anyone who applies knows that and agrees to stay within certain parameters while at work. What does that have to do with speech issues? The other criterias just aren't clear and really need additional comment.

Mar 14, '17

One issue that concerns me is the speed and high pitch that some nurses use to communicate. It is difficult to grasp what they are saying. Imagine if you are a patient in hospital and someone comes in and says "kjkjlkjglflkhdhjhgs?" to you. What could you possibly say. When we speak to a patient, it is either to give or receive information. Both types of information is very important. Give patients enough time to think about what you said or asked and then to respond. I have heard nurses going over intake assessments, completing the forms, and receiving information that was clearly incorrect or incomplete, but not asking follow-up questions, due to being in a rush. All information gathered is useful in planning the patient's care, so it is imperative that it is correct and detailed.

At present, each patient should be asked about their primary language and what language they would like to communicate in.

Lastly, just because a person's primary language is english does not mean all english is the same. There are words used in Canada, England, the Caribbean, etc. that are different to what is used in the U.S. If someone has a quizzical look on their face, it may be that they are not familiar with a word you used or the pronounciation was quite different.

Mar 14, '17

Giving "time" is inevitable and one of the most cost effective solutions.

Mar 14, '17

No matter what country you live in, but especially in the US, there are many different languages and accents around. I think for the most part people are not trying to be offensive by merely asking/inquiring about your accent. If you are a healthcare provider they are probably just trying to make small talk with you. I have had many people ask me "where are you from" or "what part of the south are you from" or "I like your southern accent" when in fact I have never even been to the south. I find this a little strange but I have never been offended by it. I have been out of the US where in fact I am not speaking the primary language of that country and have never been offended by these type of questions. As far as others have mentioned regarding people who speak loud to all people, I have done this also without even realizing it until someone mentions it, running around the hospital with how many patients, if even one is HOH you just end up doing if from habit sometimes, I had a patient tell me that I was "talking loud" and I just apologized and explained it was a "force of habit" due to the other patient, no harm done.

Also, the controversially nuanced aspects of speech differences come into play. I suspect none of these people would comment if my speech was stereotypically 'black-sounding.' But since proper English is not commonly associated with certain racial groups, people wonder how I ended up speaking the way I do.

I've seen many threads here and other discussions on the internet talking about "black-sounding" speech and how unprofessional it is to revert to that way of speaking at work. So, flipping the script for this reason, would illicit comments as well.

I'm curious too about KatieMI's comment about how religious institutions discriminate against employees. Besides a prayer being said overhead daily or a soft bell ringing every time a baby is born to celebrate, I'm hard pressed to find any way a religious institution can legally discriminate against employees.

I've seen many threads here and other discussions on the internet talking about "black-sounding" speech and how unprofessional it is to revert to that way of speaking at work. So, flipping the script for this reason, would illicit comments as well.

I'm curious too about KatieMI's comment about how religious institutions discriminate against employees. Besides a prayer being said overhead daily or a soft bell ringing every time a baby is born to celebrate, I'm hard pressed to find any way a religious institution can legally discriminate against employees.

^^this^^

also: A close friend is a doctorally prepared faculty member. She has a THICK deep South accent and described being spoken to dismissively by others in her doctoral program as if southern accent = less intelligent.

I'm curious too about KatieMI's comment about how religious institutions discriminate against employees. Besides a prayer being said overhead daily or a soft bell ringing every time a baby is born to celebrate, I'm hard pressed to find any way a religious institution can legally discriminate against employees.

The thing is, workplace bullying is legal in this country, as well as lateral violence. And that's what they do, abdolutely legally, just for someone being "different" from the crowd in any sense.

It is not a special feature of religion-based institutions, as well as it is not universal for them (at least I wish to believe so). But it seems to be more prevalent in there.

And I do not care a second for "committment" to equality as expressed by the Powers. I want it being practiced, by everyone, every day.